Exhaled Breath Condensate in Childhood Asthma: A Review and Current Perspective.

Michiel A G E Bannier,Edward Dompeling,Quirijn Jöbsis,Philippe P R Rosias

doi:10.3389/fped.2019.00150

Michiel A G E Bannier, Edward Dompeling + Show 2 more

Open Access

https://doi.org/10.3389/fped.2019.00150

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Abstract

Exhaled breath condensate (EBC) was introduced more than two decades ago as a novel, non-invasive tool to assess airway inflammation. This review summarizes the latest literature on the various markers in EBC to predict asthma in children. Despite many recommendations and two comprehensive Task Force reports, there is still large heterogeneity in published data. The biggest issue remains a lack of standardization regarding EBC collection, preservation, processing, and analysis. As a result, published studies show mixed or conflicting results, questioning the reproducibility of findings. A joint, multicenter research study is urgently needed to address the necessary methodological standardization.

Highlights

More than two decades ago, exhaled breath condensate (EBC) was introduced as a novel non-invasive diagnostic technique for various respiratory diseases
We aim to provide a concise update on markers in EBC to predict asthma in children
Earlier studies have shown increased cytokines in EBC from children with asthma and preschool wheeze compared to healthy controls (6)

Summary

Introduction

More than two decades ago, exhaled breath condensate (EBC) was introduced as a novel non-invasive diagnostic technique for various respiratory diseases. EBC is obtained by cooling exhaled breath, and mainly contains water vapor and a small fraction of volatile and non-volatile macromolecules (1, 2). These include various markers of airway inflammation, such as acidity (pH), hydrogen peroxide (H2O2), nitrogen oxides (NOx), eicosanoids, and cytokines (1, 2). Despite well-defined diagnostic criteria and the availability of lung function tests, both underdiagnosis and overdiagnosis of asthma still frequently occur (4). This is relevant in preschool children with wheezing symptoms (5). Despite two comprehensive Task Force reports of the European Respiratory Society (ERS) and American Thoracic Society (ATS) in 2005 and 2017, respectively (1, 2), there has not yet been a significant clinical breakthrough, nor the onset of methodological standardization

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